crossing96/oncoscreening huggingface dataset:
Defining good candidates for extraperitoneal cystectomy: results from random peritoneum biopsies of 136 cases.	OBJECTIVE: To define who are good candidates for extraperitoneal cystectomy. METHODS: Between April 2009 and April 2012, 136 consecutive patients (median age 63.8 years, range 35-87 years) scheduled for transperitoneal radical cystectomy were included in this study. After the bladder was removed, the peritoneum covering the bladder was detached. Any suspicious macroscopic abnormalities on the peritoneum were sampled and examined. A 6-8 point random biopsy of the peritoneum was performed for patients without gross macroscopic abnormality. RESULTS: The study group consisted of 41 patients with pT1, 48 patients with pT2, 34 patients with pT3, and 13 patients with pT4. The transitional cell carcinoma (TCC) group consisted of 123 of 136 patients (90.4%) and nonurothelial histologies of 13 of 136 patients (9.6%). In general, 8 of 136 patients (5.9%) and 14 of 816 biopsies (1.7%) were confirmed positive for peritoneum biopsies. Among them, 0 of 89 patients with pT1/2, 5 of 34 patients with pT3 (14.7%), and 3 of 13 patients with pT4 (23.1%) had positive biopsies (P <.001). In addition, 5 of 123 patients (4.9%) with TCC, 1 of 7 patients (14.3%) with adenocarcinoma, 1 of 2 patients (50%) with sarcomatoid carcinoma, and 1 of 2 patients (50%) with small cell tumors had positive peritoneum biopsies (P = .006). Among patients with positive lymph nodes, 5 of 34 patients (14.7%) had positive biopsies, compared with 3 of 102 patients (2.9%) in the lymph node-negative group (P = .012). CONCLUSION: We found that tumor stage and lymph node status are independent predictors of peritoneal involvement. Extraperitoneal cystectomy should be performed with great caution, only indicated for those patients who have a high likelihood of stage pT1 and pT2. However, patients with cT2-4, positive lymph nodes, or nonurothelial histologies should not have the peritoneum covering the bladder preserved.	bladder
Everolimus combined with cisplatin has a potential role in treatment of urothelial bladder cancer.	Cisplatin (CDDP)-based chemotherapy is a commonly treatment for advanced urothelial carcinoma. However, episodes of cisplatin resistance have been referenced. Recently it has been reported that everolimus (RAD001) could have an important role to play in bladder-cancer treatment and that mTOR inhibitors may restore chemosensitivity in resistant tumours. The aim of this study was to assess RAD001 in vitro ability to enhance CDDP cytotoxicity in three human bladder-cancer cell lines. Over the course of 72h, the cells were exposed to different concentrations of CDDP and RAD001, isolated or combined. Treatment with CDDP statistically (P<0.05) decreased cell proliferation in cell lines in a dose-dependent manner. The anti-proliferative activity of CDDP used in combination with RAD001 was statistically significant (P<0.05) in the cell lines at all concentrations tested. RAD001 had a therapeutic effect when used in combination with CDDP and could therefore be a useful anti-cancer drug combination for patients with bladder cancer.	bladder
Is cystoscopy indicated for incidentally identified bladder wall thickening?	INTRODUCTION: The purpose of this study was to evaluate the yield of cystoscopy in detecting bladder malignancy following incidentally identified bladder wall thickening observed on computed tomography (CT) scans. METHODS AND MATERIALS: Data from 3000 consecutive patients who underwent diagnostic cystoscopy at a single institution from 2006-2009 were collected retrospectively. All prior CT scan reports were reviewed, and patients whose sole indication for cystoscopy was incidentally detected bladder wall thickening were identified. Patients were categorized as diffuse thickening, focal thickening, or focal bladder mass based on the radiologist's report. Collected data included patient age, gender, race, smoking history, history of hematuria, medications for benign prostate hypertrophy or overactive bladder as well as cystoscopy results, pathology results, and follow up. RESULTS: Twenty-two patients (0.7% of cystoscopies) underwent cystoscopy for incidentally identified bladder wall thickening including 11 (50%) with focal bladder wall thickening, 8 (36.4%) with diffuse bladder wall thickening, and 3 (13.6%) with focal bladder mass lesions. Five patients (22.7%) had suspicious lesions on cystoscopy requiring endoscopic surgery with biopsy. Two patients with focal bladder mass lesions were found to have low grade, superficial bladder cancer (66.7% of patients with focal bladder mass lesions and 9.1% of all patients with incidental bladder wall thickening). No patients with diffuse or focal bladder wall thickening had malignancy. CONCLUSIONS: Incidental findings of diffuse and focal bladder wall thickening on CT scan were found to have a low yield for the detection of urinary tract malignancy. Incidentally detected focal bladder mass lesions are more likely to have malignant pathology.	bladder
The role of fascin in migration and invasion of urothelial carcinoma of the bladder.	INTRODUCTION: To investigate the roles of fascin in migration and invasiveness in bladder urothelial carcinoma. MATERIALS AND METHODS: Immunohistochemical detection of fascin in urothelial carcinoma samples and inhibition the expression of fascin in the urothelial carcinoma cell line were performed, then the differences in cell behaviors before and after silencing of the fascin gene were tested. RESULTS: In our study, we found that overexpression of fascin was more frequent in urothelial carcinoma tissues (p < 0.001). Fascin expression was positively correlated with histological grade (p = 0.024) and pT stage (p < 0.001). After transfection of fascin shRNA, the expressions of fascin in 5637 cells and BIU87 cells were efficiently decreased according to real-time RT-PCR and Western blot analysis. When fascin was inhibited, a significant decrease in migration and invasion, and increase in adhesion were observed in 5637 cells and BIU87 cells. However, there was no significant change in the proliferation of 5637 cells or BIU87 cells with or without inhibition of the fascin gene. CONCLUSIONS: Fascin expression can be used as a predictor for transformation and progression of urothelial carcinoma, and reduction of fascin levels may represent a novel therapeutic strategy for urothelial carcinoma of the bladder.	bladder
Variations in CYP isoforms and bladder cancer: a superfamily paradigm.	OBJECTIVES: The objective of this study is to examine our current understanding of molecular mechanisms involved in regulation of CYP genes to induce bladder cancer by endogenous and exogenous chemicals and to analyze the respective polymorphisms in various isoforms of xenobiotic-metabolizing gene involved in bladder cancer. METHODS: Studies revealed the molecular mechanisms of CYP genes and respective polymorphisms to demonstrate the association between xenobiotic-metabolizing gene polymorphisms and bladder cancer published from 1996 through 2012 were retrieved from MEDLINE, EMBASE and PUBMED databases. RESULTS: 22 studies met our criteria of CYP polymorphism and bladder cancer. We found that a large proportion of the published studies were small and population-based. CONCLUSION: We conclude that large, well-designed studies of common polymorphisms in CYP genes are needed. Such studies may benefit from analysis of multiple genes or polymorphisms and from the consideration of relevant exposures.	bladder
Prognostic significance of heat shock proteins in urothelial carcinoma of the urinary bladder.	AIMS: Heat shock proteins (HSPs) are a group of molecules induced by a variety of environmental and pathophysiological stresses, including cancer. The expression of HSPs has been implicated in the regulation of apoptosis and immunity in neoplasia. The purpose of this study was to evaluate the expression and clinicopathological relevance of several HSPs in urothelial carcinomas of the urinary bladder. METHODS AND RESULTS: Immunohistochemical staining for HSP27, HSP60, HSP70 and HSP90 was performed on samples collected from 744 clinical cases. The results were correlated with clinicopathological characteristics using univariate and multivariate analyses. High expression of HSP70 predicted recurrence of non-muscle-invasive urothelial carcinoma treated by transurethral resection, and low expression of HSP27 correlated with progression and cancer-specific mortality for non-muscle-invasive cancers treated by transurethral resection. Low expression of HSP27 also predicted cancer-specific mortality for patients who underwent cystectomy. CONCLUSIONS: Both HSP27 and HSP70 impact on the biological behaviour of urothelial carcinomas of the urinary bladder. Immunohistochemical assessment of HSPs can provide useful prognostic information that could ultimately help to develop individualized surveillance programmes.	bladder
Metabolic dephenylation of the rubber antioxidant N-phenyl-2-naphthylamine to carcinogenic 2-naphthylamine in rats.	N-Phenyl-2-naphthylamine (P2NA) was widely used as oxidation inhibitor, particularly in rubber manufacturing. Technical-grade P2NA was contaminated with carcinogenic 2-naphthylamine (2NA), and bladder cancer risk in exposed workers was attributed to this impurity. Investigations in humans and mammalian species revealed that small amounts of 2NA are excreted into urine after exposure to P2NA. However, since 2NA per se is not carcinogenic and main downstream metabolites of 2NA have not been found in urine so far, it remained uncertain if 2NA derived from P2NA dephenylation is further activated to carcinogenic downstream metabolites. An experimental animal study was therefore designed to indicate if, and if yes to which extent, 2NA from P2NA dephenylation is accessible to the metabolic pathway that is held responsible for the carcinogenicity of 2NA. Groups of 5 male and female CD rats were dosed with P2NA (2-550 mg/kg b.w.) and 2NA (0.075-75 mg/kg b.w.); 2NA-haemoglobin adducts and urinary 2NA excretion were determined applying GC-MS/MS. 2NA haemoglobin adducts originated dose-dependently after 2NA and P2NA dosing. To induce identical adduct concentrations, an approximately 100-200-fold higher dose of P2NA was necessary compared to 2NA. Since haemoglobin adducts are formed by the same pathway (N-hydroxylation) as the ultimate carcinogens from 2NA, the comparison of adduct concentrations after 2NA and P2NA dosage permits a quantitative estimate of the carcinogenicity of P2NA. The results show that 2NA derived from dephenylation of P2NA enters the carcinogenic downstream pathway of 2NA in rats. Hence, the bladder cancer risk after human exposures to P2NA must be re-evaluated.	bladder
Magnolol suppresses hypoxia-induced angiogenesis via inhibition of HIF-1α/VEGF signaling pathway in human bladder cancer cells.	The hypoxic environment in tumors is an important factor causing tumor angiogenesis by activating the key transcription factor, hypoxia-inducible factors-1α (HIF-1α). Magnolol isolated from Magnolia officinalis has been reported to exhibit an anticancer activity via elevation of apoptosis. However, whether magnolol inhibits tumor angiogenesis remains unknown. In the present study, we demonstrated that magnolol significantly inhibited angiogenesis in vitro and in vivo evidenced by the attenuation of hypoxia and vascular endothelial growth factor (VEGF)-induced tube formation of human umbilical vascular endothelial cells, vasculature generation in chicken chorioallantoic membrane and Matrigel plug. In hypoxic human bladder cancer cells (T24), treatment with magnolol inhibited hypoxia-stimulated H2O2 formation, HIF-1α induction including mRNA, protein expression, and transcriptional activity as well as VEGF secretion. Additionally, the enhanced degradation of HIF-1α protein via enhancing prolyl hydroxylase activity and the decreased newly-synthesized HIF-1α protein in hypoxic T24 cells may involve the reduction of HIF-1α protein accumulation by magnolol. Interestingly, magnolol also acts as a VEGFR2 antagonist, and subsequently attenuates the down-stream AKT/mTOR/p70S6K/4E-BP-1 kinase activation both in hypoxic T24 cells and tumor tissues. As expected, administration of magnolol greatly attenuated tumor growth, angiogenesis and the protein expression of HIF-1α, VEGF, CD31, a marker of endothelial cells, and carbonic anhydrase IX, an endogenous marker for hypoxia, in the T24 xenograft mouse model. Collectively, these findings strongly indicate that the anti-agngiogenic activity of magnolol is, at least in part, mediated by suppressing HIF-1α/VEGF-dependent pathways, and suggest that magnolol may be a potential drug for human bladder cancer therapy.	bladder
[A case of fistula of small intestine and ileal conduit urinary diversion improved by conservative therapy].	A 71-year-old male was admitted for bladder cancer, and we performed a radical cystectomy and urinary diversion by means of an ileal conduit. Twenty days postoperatively, we identified the presence of stool in the stoma and noted the existence of a fistula of the small intestine and ileal conduit urinary diversion. Treatment with fasting, intravenous hyperalimentation and intravenous drip administration of octreotide acetate were performed. The fistula was closed completely 47 days after the surgery. The early complications of urinary diversion by means of an ileal conduit were reported to be urinary tract infections, bowel obstruction, and delayed wound healing, but a fistula between the small intestine and ileal conduit is very rare. We herein report a case of a fistula between the small intestine and ileal conduit used for urinary diversion which thereafter healed by conservative treatment.	bladder
Influence of previous or synchronous bladder cancer on oncologic outcomes after radical nephroureterectomy for upper urinary tract urothelial carcinoma.	OBJECTIVE: The objective of the study was to evaluate the effect of a history of bladder cancer (BC) or synchronous BC on the prognosis and survival of patients who have undergone radical nephroureterectomy (RNU). METHODS AND MATERIALS: Using a multi-institutional, retrospective database, we identified 662 patients with upper urinary tract urothelial carcinoma (UUT-UC) treated by radical nephroureterectomy, between 1995 and 2010. We analyzed clinicopathologic characteristics and outcomes according to the history of BC or concomitant BC or both, at the time of diagnosis. BC was evaluated as a prognostic factor for bladder recurrence and survival. RESULTS: Overall, 83 (12.5%) patients had previous BC, 62 (9.4%) exhibited concomitant BC, and 75 (11.3%) presented with both previous and current BC. A history of BC was less seen in women and nonsmokers (P<0.0001 and P = 0.013, respectively). The patients with associated BC had more tumors located in the ureter (P<0.0001), as well as more multiple locations in the upper tract (P<0.0001). The tumors without concomitant BC were more likely to be associated with locally advanced stages (P = 0.024). At a median follow-up time of 37.3 months, 31.4% of patients experienced BC recurrence and 2.9% developed contralateral upper tract tumor. Using multivariate analyses, the previous or synchronous BC (P = 0.01) and positive surgical margins (P = 0.03) are independent prognostic factors for BC recurrence. The metastasis-free survival and cancer-specific survival rates did not significantly differ according to the associated BC status. CONCLUSIONS: In patients without previous or concomitant BC, the upper tract tumors are more frequently localized in the renal pelvis and are associated with a more invasive status at the time of diagnosis. Nevertheless, the presence of UUT-UC without previous or synchronous BC did not significantly affect the survival rates after nephroureterectomy.	bladder
Upregulated H19 contributes to bladder cancer cell proliferation by regulating ID2 expression.	Long noncoding RNAs have been shown to have important regulatory roles in cancer biology, and long noncoding RNA 19 (H19) is essential for human tumor growth. However, little is known about how abnormal expression of H19 contributes to bladder cancer cell proliferation. In this study, we first evaluated the expression of H19 in bladder cancer tissues by real-time PCR, and defined the biological functions. We found that H19 expression levels were remarkably increased in bladder cancer tissues as compared with adjacent normal control tissue, and forced expression of H19 promoted bladder cancer cell proliferation in vitro. Inhibitor of DNA binding/differentiation 2 (ID2) expression levels were upregulated in bladder cancer tissues and in bladder cancer cells. A significant positive correlation was observed between H19 levels and ID2 levels in vivo. We further demonstrated that overexpression of H19 resulted in a significant increase in the expression of ID2, whereas H19 knockdown decreased ID2 expression in vitro. Gain-of-function and loss-of-function studies demonstrated that upregulated H19 increased bladder cancer cell proliferation by increasing ID2 expression. In conclusion, upregulated H19 increases bladder cancer growth by regulating ID2 expression, and thus may be helpful in the development of effective treatment strategies for bladder cancer.	bladder
Cutaneous ureterostomy with definitive ureteral stent as urinary diversion option in unfit patients after radical cystectomy.	PURPOSE: Simple diversions are underutilized, mostly for unfit, bedridden, and very self-limited patients requiring palliative surgical management due to life-threatening conditions. Experience with cutaneous ureterostomy (CU) as palliative urinary diversion option for unfit bladder cancer patients is reported. METHODS: We retrospectively reviewed clinical and operative parameters of 41 patients who underwent CU following RC in three specialized Cancer Centers from July/2005 to July/2010. Muscle-invasive disease (clinical Stage T2/worse), multifocal high-grade tumor, and carcinoma in situ refractory to intravesical immunotherapy were the main indications for RC. Double-J ureteral stents were used in all patients and replaced every 6 months indefinitely. Peri-operative morbidity and mortality were evaluated. RESULTS: Median age was 69 years (interquartile range--IQR 62, 76); 30 (73%) patients were men. Surgery in urgency setting was performed in 25 (61%) of patients, most due to severe bleeding associated with hemodynamic instability; 14 patients (34%) showed an American Society of Anesthesiologists score 4. Median operative time was 180 minutes (IQR 120, 180). Peri-operative complications occurred in 30 (73%) patients, most Clavien grade I and II (66.6 %). There was no per-operative death. Re-intervention was necessary in 7 (17%) patients. Overall survival was 24% after 9.4 months follow-up. CONCLUSIONS: CU with definitive ureteral stenting represents a simplified alternative for urinary diversion after palliative cystectomy in unfit patients. It can be performed quickly, with few early and late postoperative complications allowing RC in a group of patients otherwise limited to suboptimal alternatives. Future studies regarding the quality of life are warranted.	bladder
[Urinary diversions and bladder replacement surgery: evolution, current situation and long-term outcomes].	"Nowadays, radical cystectomy represents the first choice of therapy for muscle invasive bladder cancer. The first choice after radical cystectomy, both in male and in female patients, is no more urinary diversion, but bladder replacement surgery through orthotopic reconstruction. The ileal conduit is considered a safe procedure and the gold standard to which newer forms of urinary diversion should be compared, although few long-term results are known. Currently, neobladder is the most important urinary diversion in the world, followed by Bricker's ileal conduit. We evaluated the long-term results of the most important forms of urinary diversions, analyzing some data available in the Literature. Then, we focused our attention on long-term outcomes of our ""Y Neobladder"": functional outcome and long-term complications. At last, we critically examined the widely accepted notion that patients undergoing ""Y Neobladder"" experience superior quality of life outcomes than patients receiving an ileal conduit."	bladder
Different subtypes of carcinoma in situ of the bladder do not have a different prognosis.	Urothelial carcinoma in situ (CIS) is a high-grade lesion with different subtypes (large cell pleomorphic (LCP), large cell nonpleomorphic (LC), small cell and clinging (CL)). We explored the frequency of different subtypes in primary CIS and compared different patterns with outcome. We explored whether subtyping of CIS leads to a change in therapy and/or follow-up and should be formally reported. We included 39 patients with a primary CIS and divided them into two groups: one with LPC/LG and one with CL elements. Other subtypes did not exist or occurred only as a mixture. Patient age ranged from 36 to 80 years (mean, 63 years). Twenty had a primary CIS with one single subtype. LCP was predominant with 16 (41 %) cases; the second most important subtype was the CL with four (10 %) cases. Mean follow-up was 26.4 months, (range, 4-100 months). Thirteen patients developed a ≥ pT2 carcinoma. When progression of the different subtypes was examined, no statistical significance was found between mixed forms (p = 0.9437) nor between pure forms (p = 0.744 and p = 0.5955, respectively). Pathologists need not include different subtypes of primary CIS in their report as there is no difference in patient outcomes. It is important to recognize all different subtypes as CIS for best patient treatment.	bladder
High-grade non-muscle-invasive bladder cancer: is re-resection necessary in all patients before intravesical bacillus Calmette-Guérin treatment?	OBJECTIVE: According to current European Association of Urology (EAU) guidelines, a routine second transurethral resection (TUR) is mandatory in TaG3 and T1 tumours, but the scientific evidence is weak. The aim of this study was to report outcome data for patients not subjected or subjected to a routine second resection. MATERIAL AND METHODS: This retrospective study included 221 patients with a newly diagnosed TaG3 or T1 bladder cancer treated with intravesical bacillus Calmette-Guérin (BCG). RESULTS: A routine second resection or a repeat resection was done in 57 out of 221 patients (25.8%). During the first year, progression was diagnosed in 0/10 patients with TaG3, 2/12 with T1G2 and 5/35 with T1G3. Among 164 not subjected to a second resection, the progression rate during the first year was 0/56 for patients with TaG3, 1/30 for T1G2 and 8/78 for T1G3. The median age among all 16 patients with T1 tumours who progressed during the first year was 77.5 years (27-94 years). Twenty-five TURs (25/164, 15.2%) were performed among the 164 patients because of a tumour at the first cystoscopy. The majority (84/164, 51.2%) had no recurrences during a median follow-up of 45 months. CONCLUSIONS: The initial outcome was very good for TaG3 patients, so a routine re-resection may be unnecessary. However, progression among T1 patients was common, and therefore a re-resection should be strongly considered. The potential benefit of a second TUR should be weighed against costs and morbidity in a predominantly elderly population. The absence of prospective randomized studies is problematic.	bladder
Current role of PET, CT, MR for invasive bladder cancer.	Imaging for urothelial cancer, particularly that located in the bladder, has generally been based on computed tomography (CT). However in more recent times the role of positron emission tomography-CT (PET-CT) has emerged and increasingly magnetic resonance (MR) imaging has become utilised. This concise review will outline the role of these modalities when dealing with muscle-invasive bladder cancer (MIBC).	bladder